At AMP, one of our primary roles is to identify areas of opportunity at dental practices. It's no secret that in most practices there is a lot of treatment that is recommended but goes undone. Sometimes, the amount of this is shocking. I have seen practices with literally millions of dollars of treatment that was recommended and never done.  

But the word “treatment” can encompass many things. It could be an x-ray, a cleaning, or a crown. Or something bigger. I'll bet that your case acceptance rate on cleanings is pretty high.  It's those bigger treatment plans that most often go undone.   A dental implant is a good example of this.  When a patient has a missing tooth and is asymptomatic, an implant just doesn't seem to be that important.   Until the patient realizes the importance of replacing that missing tooth or teeth, he or she will be very price sensitive. And it's not comparing your fees to other dentists’… It's comparing your fee to items they want more, like that new flat-screen TV or iPhone.

One of my primary functions as a coach is to help doctors and their staff explain things better to help build value to the patient. We never recommend aggressive treatment plans or over-treating. We help you to better address those items that you normally would treatment plan. And we don't recommend a hard sell or special techniques and tricks to bully the patients.   Instead, we work on honest narratives that the doctor can have with the patient to gain understanding, build value, and therefore increase case acceptance.

When a treatment plan consists of, for example, three fillings and a dental implant, it is common to hear the patient say “I'll do the three fillings, but I need to think about the implant.”  Do you hear this a lot? To do more of the implants you recommend, we have to figure out how to get past this barrier.

If you need help with your narratives, please let me know. You might find that some simple changes can do two great things: help your patients return their mouths to a state of dental health, and help your business grow. Isn't it wonderful when you can do both at the same time?  That is a true win-win situation.

A majority of dental practice management software has an easily-used function to view patients who are due or overdue for recall. These lists should be constantly managed and specific systems should be in place to contact and schedule these patients.  The fact is, in 25 years of practice, I have found that patients who are otherwise high-functioning adults are completely unable to remember that it’s a good idea to visit the dentist twice a year without one, or even several, reminders.  Crazy, huh?  So, let’s keep texting, emailing, and calling the folks on the recall list.

Today, I’d like to talk about a different list. This is a list of patients that do not appear on the recall list and yet still need to be contacted. There are several reasons why patients might be in such a situation.  Generally, they fall into two categories: 

1. Patients who have only been seen for emergency treatment and have never had a new comprehensive visit.
2. Patients who have never been seen in the office, yet are still are listed as active patients.

First: Patients with NO comprehensive visits

The first category is easy to solve. We can run a report of people who have a specific last visit date shown in their charts and yet no continuing care or recall schedule. These people need to be contacted by the office and hopefully will become comprehensive care patients. I always suggest going in order of date, starting with the people who were seen most recently and going back in time from there. The most recent ones are the easiest to contact. Once we get a few years into the past, it will be harder to have up-to-date contact information. Many of these patients simply need to be inactivated.

Second: Never Seen before patients

The second category has several possibilities as to why a patient is active yet has no last visit and/or recall date.  Therefore, a bit of research is necessary on each individual to figure it out.  Here are some possibilities:

1. The patient is incorrectly categorized in the chart as an active patient. This person may in fact be a guarantor or policyholder and not a true patient. This is a matter of correcting the error.
2. The patient may be scheduled as a new patient in the future. This will self-correct, of course.
3. There may be an error in the chart where the last visit date is blank.  Correct this.
4. The patient may have been scheduled as a new patient and failed the appointment. The decision needs to be made whether we will contact this person for another chance or not. This should be done in conjunction with the office manager or doctor on an individual basis.

In sum, it is very important that we continue to encourage our patients to maintain a proper recall. The very basis of this is proper maintenance of our database to make sure each and every patient is correctly shown on the appropriate reports and contacted when due. If you have a lot of people who do not have a proper recall or continuing care schedule set up, I suggest you solve just a few, maybe 5 to 10, per day. This effort will go a long way over the years to keep your database clean.

If you need help generating the necessary reports for this, please let us know!  We are happy to help.

Let's imagine a scenario, not one too far fetch from that of dental case presentation. There is a weird noise coming from your car. There is a weird noise coming from your car, so you take it to the repair shop.   The shop owner himself takes a look at the car. He then says, “I would like to sit down with you and talk about this problem.”

“The transmission is a part of the overall drive system of the car. It adapts the output of your internal combustion engine to the wheels.  Internal combustion engines need to operate at a high rotational speed which can cause problems with starting, stopping, and slow travel unless geared down. The transmission will reduce the higher engine speed to a slower speed at the wheel, increasing torque.  It is connected to the crankshaft with a flywheel and then to the drive wheel via a driveshaft and differential. The valve body shifts gears using fluid pressure in response to throttle input.  Your torque converter has malfunctioned. Usually it will multiply torque when the rotational speed of the engine is low and allows fluid coming off the curved veins of the turbine to be deflected off the stator which is locked against a one-way clutch.”

“There are 3 options to solve this.  I can replace the transmission with a new part, replace it with a remanufactured part, or attempt to rebuild the transmission myself.” says the shop owner. 

“Let’s go over each option thoroughly.  I have some diagrams and pictures of the inside of transmissions.  Or, you can watch a 5-minute video on trans----.”

“OK!” you say, cutting him off and completely confused.  Unable to really know what’s best, you only come up with one question: “How much will those cost?”

 “I’m not sure; I’ll need to send in someone else to talk about that,” says the shop owner who knows everything.

That’s odd, I think to myself.  After all that, he doesn't even know what his own shop charges.  How can I trust all that other nonsense he told me?

Maria arrives, the shop owner disappears, and a talk about money ensues.  Options, zero-interest financing, more options, 5% prepayment discount.  You are frozen.

“I will need to think about it,” you mutter, defeated.  And head back to your dental office.  Moments later, you are back in your comfort zone, explaining to people about strep mutans and zirconia versus e.max, teaching where the DEJ is on x-rays, and offering lots of treatment options.

And worrying about the cost of the new transmission.

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Do you need help with dental case presentation?  Ask us!